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Definition
A secondary transportation provider or service recovery mechanism activated when the primary provider fails to perform a scheduled trip (a "turnback" or "no-show").
Overview
Why it Matters
Brokers are contractually obligated to ensure "No Member Left Behind." If a provider drops a trip last minute, a Back-up Service (often a higher-cost taxi or TNC like Uber Health) is deployed.
How it Works
The primary provider notifies the Broker they cannot do the trip. The Broker effectively "rescues" the trip by assigning it to a Back-up provider, often penalizing the primary provider for the cost difference.
Code Comparison
Comparison: Back-up vs. Overflow
Overflow is planned capacity management (contracting out extra trips days in advance). Back-up is reactive emergency management (finding a ride now because someone failed).
Common Questions
- High Cost: Back-up providers (like Taxis) often charge meter rates, which are significantly higher than NEMT contract rates.
- Vetting: In emergency back-up scenarios, verifying that the rescue vehicle has the specific medical equipment needed (e.g., right-sized wheelchair lift) can be rushed.
- Maintain a "Tier 2" network of reliable providers who accept last-minute trips for a premium.
- Track "Turnback Rates" aggressively; if a provider constantly relies on back-up services, they should be removed from the network.
Sources
Modivcare (formerly LogistiCare) Provider Manuals - Service Recovery